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New Patient Form

Dix Animal Hospital asks for all new clients to please complete our New Patient Form, so that we can hit the ground running and provide the best quality care for your pet.

Option 1

Complete Online

Complete and submit the online form below.

Option 2

Print & Complete

Bring the completed form with you to our hospital.

Download Form

Option 3

Complete on Arrival

If you prefer, fill out the form when you get to our hospital.

New Patient Form

Owner Information

Emergency Contact

Patient Information

Primary Veterinarian Information

Please fill this section in if we are not your primary care veterinary hospital. By listing your primary care veterinarian, you are authorizing Dix Animal Hospital to release patient information to the primary care hospital or veterinarian.
By submitting this form, I hereby authorize Dix Animal Hospital to render medical care for my pet(s) as deemed necessary by the veterinarian. I understand that no guarantee can be given to the outcome of treatments and take it as my responsibility to comprehend any risks involved. I agree to pay for the cost of all services to which I consent to by written or verbal estimate. I understand that a deposit is required before diagnostics and treatments can be initiated and that payment in full is required prior to discharge of patient from Dix Animal Hospital.

New Patients Welcome

Dix Animal Hospital is accepting new patients! Our experienced vets are passionate about the health of Lincoln Park companion animals. Get in touch today to book your pet's first appointment.

Contact Us

Book Online (313) 383-7387